Silver PPO 4000/0/45 Rx 250
Capital Advantage Assurance Company · 2027 plan year
Silver
- Ind. medical deductible
- $4,000
- Rx deductible (separate)
- $250
- Family deductible
- Not listed
- Ind. OOP max
- $10,700
- Family OOP max
- Not listed
This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.
Compare with other Silver plans in PA
Side by side: deductibles, out-of-pocket limits and copays.
More Capital Advantage Assurance Company plans in PA
Monthly premiums by age
Rating Area 6 — the lowest-priced of the 3 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $624 | $624 |
| 21 | $815 | $835 |
| 30 | $925 | $948 |
| 40 | $1,042 | $1,120 |
| 50 | $1,456 | $1,674 |
| 60 | $2,212 | $2,765 |
| 64 and over | $2,445 | $3,057 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Primary Care Visit to Treat an Injury or Illness | $45.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $80.00 |
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